肿瘤外科临床药师参与结直肠外科患者的药学监护实践

Clinical Pharmacists in Oncology Surgery Participate in the Practice of Pharmacological Care for Patients in Colorectal Surgery

目的探讨肿瘤外科临床药师药学监护重点。方法总结归纳肿瘤外科临床药师在结直肠病区中的临床药学实践,以1例典型的结直肠癌肝转移综合治疗患者多学科(MDT)诊疗模式为例,阐述肿瘤外科药师在MDT团队工作的切入点及围术期药学监护重点。结果结合肿瘤MDT的治疗模式,初步摸索出肿瘤外科临床药师的常规工作药学监护关键点。临床药师针对拟进行肿瘤外科治疗患者药物治疗相关问题提出意见和建议,优化术前抗肿瘤药物用药史与手术的间隔时间、围术期的营养支持治疗的制定、肿瘤患者深静脉血栓的预防、出院后患者用药教育等。结论作为MDT团队成员之一,肿瘤外科药师参与并实施药学监护后,有利于保障患者用药安全、有效,改善患者预后,发挥药学专业优势,体现药学服务的价值。

OBJECTIVE To discuss the key points of pharmacological care for clinical in oncology surgery.METHODS The clinical pharmacy practice of pharmacists in oncology surgery in the colorectal ward were summarized.A typical multidisciplinary team(MDT) diagnosis and treatment model of a typical patient with liver metastasis from colorectal cancer was selected.And the entry point and the focus of perioperative pharmaceutical care were explained at the work of the oncology surgery pharmacist in the MDT team.RESULTS Combined with the treatment mode of oncology MDT,the key points of routine work pharmacy care of clinical pharmacists in oncology surgery were initially explored.Clinical pharmacists put forward opinions and suggestions on drug treatment-related issues for patients who were planning to undergo surgical treatment of tumors,optimized the preoperative history of antitumor drug use and the interval between surgery,the formulation of perioperative nutritional support treatment,the prevention of deep vein thrombosis in oncology patients,post-discharge patient medication education,etc.CONCLUSION As a member of the MDT team,after the oncological surgeon pharmacist participates in and implements pharmaceutical care,it will ensure the safety and effectiveness of patients’ medication,improve patient prognosis,give full play to the professional advantages of pharmacy,and reflect the benefits of drug services value.